Homeland Security and Emergency Management

Homeland Security and Emergency Management

State Homeland Security Exercise and Evaluation Program Application

STATE OF NEW HAMPSHIRE

DEPARTMENT OF SAFETY

HOMELAND SECURITY AND EMERGENCY MANAGEMENT

HSEEP

GRANT APPLICATION PACKET

APPLICANT: ______

SECTION ISUMMARY INFORMATION

SECTION IIEXERCISE DESCRIPTION

SECTION IIIBUDGET REQUEST

SECTION IVSIGNATURE & CERTIFICATION PAGE
APPENDIX AOVERTIME AND BACKFILL POLICY

APPENDIX BPERSONNEL CALCULATION SHEET

Directions: If filling out electronically, this application has shaded fields for easier entry. To make this possible, the document is locked/protected. If you need to fill in information outside of these shaded fields, you must turn off this protection. To do this, please do one of the following:

• On the Tools menu, click Unprotect Document, or

(To be filled in by NH HSEM)
Date received:
Initials:
Grant Amount:
Status:
Funding Year:
Event Type:
Event Date:

• On the Forms toolbar, click Protect Form

To go back to filling in the fields, you will need to do one of the following:

• On the Tools menu, click Protect Document, or
• On the Forms toolbar, click Protect Form

Applicant Organization/Agency Name:

______

I.SUMMARY INFORMATION

A.Exercise Type/Topic and Date 100% Cost of Project(s)

1. / $
2. / $
3. / $
4. / $
*Total Cost of Projects (100%)* / $

B.Contact Information

Primary Contact: Alternate Contact:

Name: / Name:
Title: / Title:
Street Address: / Street Address:
Mailing Address: / Mailing Address:
Community/Zip: / Community/Zip:
Phone: / Phone:
Email: / Email:

C. Exercise location:

D. Does your community have an Emergency Operations Plan (EOP)?

• When was it last updated? (mm/dd/yyyy or N/A)

• When was the last time you exercised/drilled your EOP? (mm/dd/yyyy or N/A)

• When was the last time your EOC was operational? (mm/dd/yyyy or N/A)

Was it operational for a disaster or an exercise/drill?

II.EXERCISE DESCRIPTION

1. Core Capabilities- Please select three (3) to five (5) capabilities that will be tested in this exercise:

1. PlanningPublic Information and WarningOperational CoordinationForensics and AttributionIntelligence and Information SharingInterdiction and DisruptionScreening, Search, and DetectionAccess Control and Identity VerificationCybersecurityPhysical Protective MeasuresRisk Management for Protection Programs and ActiviSupply Chain Integrity and SecurityCommunity ResilienceLong-term Vulnerability ReductionRisk and Disaster Resilience AssessmentThreats and Hazard IdentificationCritical TransportationEnvironmental Response/Health and SafetyFatality Management ServicesInfrastructure SystemsMass Care ServicesMass Search and Rescue OperationsOn-scene Security and ProtectionOperational CommunicationsPublic and Private Services and Resources
2. NonePublic Information and WarningPlanningOperational CoordinationForensics and AttributionIntelligence and Information SharingInterdiction and DisruptionScreening, Search, and DetectionAccess Control and Identity VerificationCybersecurityPhysical Protective MeasuresRisk Management for Protection Programs and ActiviSupply Chain Integrity and SecurityCommunity ResilienceLong-term Vulnerability ReductionRisk and Disaster Resilience AssessmentThreats and Hazard IdentificationCritical TransportationEnvironmental Response/Health and SafetyFatality Management ServicesInfrastructure SystemsMass Care ServicesMass Search and Rescue OperationsOn-scene Security and ProtectionOperational Communications
3. NonePlanningPublic Information and WarningOperational CoordinationForensics and AttributionIntelligence and Information SharingInterdiction and DisruptionScreening, Search, and DetectionAccess Control and Identity VerificationCybersecurityPhysical Protective MeasuresRisk Management for Protection Programs and ActiviSupply Chain Integrity and SecurityCommunity ResilienceLong-term Vulnerability ReductionRisk and Disaster Resilience AssessmentThreats and Hazard IdentificationCritical TransportationEnvironmental Response/Health and SafetyFatality Management ServicesInfrastructure SystemsMass Care ServicesMass Search and Rescue OperationsOn-scene Security and ProtectionOperational Communications
4. NoneSituational AssessmentEconomic RecoveryHealth and Social ServicesHousingNatural and Cultural ResourcesPublic and Private Services and ResourcesPublic Health and Medical Services
5. NoneSituational AssessmentEconomic RecoveryHealth and Social ServicesHousingNatural and Cultural ResourcesPublic and Private Services and ResourcesPublic Health and Medical Services

1. Please list any training that will be needed prior to the exercise:

1. Please list any equipment the was previously purchase with FEMA or Homeland Security funds that will be used in this exercise:

1. Exercise Narrative – please explain how this event will enhance emergency management capabilities. If applicable, include other agencies participating, a timeline of planning meetings and exercise dates, and what plans are being tested.

III.Budget Request

The following are allowable expense categories:

1. Planning, Design, and Development
   

Applicants may receive funding for the planning time spent designing and developing the exercise. This may include pre-time for planning meetings, planning meetings, and administrative costs. The services of contractors/consultants may be procured to support the design, development, conduct and evaluation of exercise. A note that any contractors/consultants selected must be familiar with the Homeland Security Exercise Evaluation Program (HSEEP) guidance.

Complete Appendix B: Personnel Calculation Sheet for all planning related costs

Attach the community’s formal written procurement policy or the Federal Acquisition Regulations (FAR), whichever is more stringent, must be followed.

Quotes from at least three contractors/consultants must be provided.

An invoice with a detailed outline of contracted services.

Signed contract agreement between community and contractor.

Amount Requested for Contractors/Consultants:$

1. Overtime and Backfill
   

Overtime and backfill costs associated with the design, development, and conduct of exercises are allowable expenses. Payment of overtime expenses will be for work performed by award (SAA) or sub-award employees in excess of the established work week related to the planning and conduct of the exercise project(s). In the case of part-time, paid-for-call, paid-on-call, paid-per-call and volunteer personnel, overtime is considered in excess of what they typically work in a week, but at their regular rate of pay or call rate, not at an overtime (time-and-a-half) rate. See Appendix A: Overtime and Backfill Policy

Complete Appendix B: Personnel Calculation Sheet

Amount requested for Overtime and Backfill: $

1. Supplies
   

Supplies are items that are expended or consumed during the course of the planning and conduct of the exercise project(s) (e.g., copying paper, gloves, tape, non-sterile masks, and disposable protective equipment).

Attach an itemized breakdown of supplies

Amount requested for Supplies: $

1. Food
   

Only one meal is allowed for reimbursement per 4 hour time block. Refer to GSA per diem rates for food expense guidelines

Attach an itemized breakdown of food

Amount requested for Food: $

1. Other Items
   

These costs include the rental of space/locations for exercise planning and conduct, rental of equipment (e.g., portable toilets, tents), food, refreshments, exercise signs, badges, etc.). You must tie event costs to the exercise.

Attach an itemized breakdown of items

Amount requested for other items: $

Total Amount Requested $

IV.SIGNATURE & CERTIFICATION PAGE

PLEASE NOTE: Applications that do not contain all of the requested information, including any necessary attachments, will be followed up on. Priority will be given to applications that are all-inclusive.

The NH Department of Safety, Homeland Security and Emergency Management shall reserve the right to verify any statement or answer given on an application for a grant under this part where good cause exists. Good cause shall include, but not be limited to the following:

[1] A false statement or answer in an application; or

[2] A change in the applicant's criteria which has not been reported on the application; or

[3] Inconsistent or inaccurate statements in prior applications.

Excluded Parties List

I certify that none of the vendors, contractors, or sub-contractors being used for this exercise is listed on the Federal Excluded Parties List. Further I certify that I have checked the Federal Excluded Parties List found at

***To confirm that none of the vendors, contractors, or sub-contractors are on the Federal Excluded Parties List complete this steps:

1. Visit
2. In the “Quick Search” field type in the name of the vendor
3. Complete for each vendor

Certification

MEMORANDUM OF ACKNOWLEDGEMENT BETWEEN THE STATE OF NEW HAMPSHIRE AND THE LOCAL TOWN/CITY REGARDING STATE USE OF HOMELAND SECURITY GRANT FUNDING ON BEHALF OF THE LOCAL TOWN/CITY

The purpose of this Agreement is to set forth terms by which the State of New Hampshire shall expend Homeland Security Grant Funding on behalf of local towns and cities. The United States Department of Homeland Security (DHS) issued grant numbers EMW-2011-SS-00079 and/or EMW-2012-SS-0084 to New Hampshire.

Under this grant, the State of New Hampshire must allocate a minimum of 80% of grant funding to local towns and cities. The undersigned acknowledges that the State of NH Department of Safety has held a portion of the Local allocation (80% funds) to facilitate a more robust Exercise program in accordance with DHS grant objectives on behalf of the local entities. 80% funds will be used strictly on eligible costs for Local agency first responders participating in this specific HSEEP exercises.

Under this grant, the State of New Hampshire will provide support and exercise training for this purpose of participation with the locals in this DHS/Department of Safety (DOS) approved exercise. This exercise is coordinated by the Department of Safety – Division of Homeland Security and Emergency Management.

I certify that the statements in this application are true and correct to the best of my knowledge. Should my jurisdiction be chosen to receive this grant, I acknowledge that I will comply with conditions of the grant.By signing below I acknowledge 80% local funds are being used for Local Agency participation:

‘______

Print/Type Name and Title of Grant CoordinatorSignature

Date

Email completed application to:

NH Department of Safety

Homeland Security and Emergency Management

Attn: Exercise Training Officer

33 Hazen Drive

Concord, NH 03305

(603) 223-3627

APPENDIX A: OVERTIME AND BACKFILL POLICY

OVERTIME AND BACKFILL POLICY FOR DHS-APPROVED TRAINING Exercises

UNDER SHSGP FISCAL YEARS 2014, 2015 AND BEYOND

1.Scope

This policy shall take affect immediately and will apply to exercises for eligible pre-approved exercise applications based on SHSGP fiscal years 2014, 2015 and beyond. This policy shall not be precedent setting for any other classes, programs or grant periods.

2.Policy:

The policy set forth shall be for all first responders that participate in pre-approved HSEEP exercises.

A. General Conditions

1. Under no circumstances is dual compensation allowed.

2. There is no reimbursement for straight time pay except in the cases of part time, paid-per-call or volunteer stipends.

3. The maximum allowable reimbursement is set by the Commissioner of the NH Department of Safety at $650 per person per day

Only expenses outlined in this document shall be eligible for reimbursement.

Reimbursement for Overtime and/or Backfill will be paid to the community. The Grant reimbursement is intended to make a “municipality whole” for the participation of an employee in training or exercises.

B. FULL TIME PERSONNEL

Communities will be reimbursed for full time personnel participating in eligible training and exercises under the following conditions:

Overtime

Full time personnel who are paid overtime to attend training will be reimbursed for actual time in class; i.e. 8 hours of pay for an 8 hour class. Travel time and/or mileage are not eligible.

Backfill

Full time personnel who are called in on overtime to cover a duty shift for another member who is on-duty and receiving straight time to attend training (backfill) will be reimbursed for the actual class time only as outlined above. Travel time and/or mileage are not eligible.

It is expected that the responder who is assigned to training in lieu of normal duty and whose shift is being covered will return to duty to complete their normal shift assignment.

C. PART-TIME PERSONNEL

If an agency has budgeted employees to work less than a full time schedule, the time that these employees spend traveling to and attending approved training above and beyond their regularly scheduled hours can be considered overtime and therefore covered. For example, if an agency budgets an individual for 20 hours per week but approved training activities require that person to work 25 hours in a week, the additional 5 hours spent in training could be covered by SHSGP grants.

D. PAID-FOR-CALL, PAID-ON-CALL, AND PAID-PER-CALL VOLUNTEER PERSONNEL

If an agency relies upon paid-for-call, paid-on-call, and/or paid-per-call volunteer personnel and opts to include them in approved training and exercises, grantees can use SHSGP grant funds to pay volunteers for their attendance at these activities in accordance with established processes. These Communities will be reimbursed for their members to attend training based on their documented rate of pay.

E. STIPENDS FOR VOLUNTEER FIRST RESPONDERS

Stipends for purely volunteer first responders to attend approved training are allowable when volunteers are completely unpaid and no legal agreement exists to support pay for training activities with the following justification:

These Communities will be reimbursed for actual class time at the rate of $20.80 per hour. Student travel time and mileage expenses are not eligible.

All funds will be paid to the community.Students will not receive payment made out to them.

F. FILING PROCEDURE

The following procedure must be followed by all Communities seeking reimbursement of payroll costs as outlined in this policy:

All documentation packages must be submitted to NH HSEM for initial review as soon as possible following the completion of the exercise/class. The following documents must be submitted as part of this package:

1. Successful completion of the After Action Report with Improvement Plan.

1. Completed NH Department of Safety Overtime/Backfill Reimbursement Forms for each person for whom reimbursement is being requested, signed by an authorized official.

1. Payroll documentation to support the requested reimbursement, signed by an official authorized to approve payroll.

1. Summary sheet listing the employee name, date of training, rate of pay, hours, benefits by percentage and total amount requested, signed by an authorized official. Benefits are limited to FICA, Workers Compensation, Unemployment Compensation and Retirement rate in effect at the time of the exercise/training.

1. Volunteer Stipend Justification (if applicable), signed by an authorized official.

1. Invoice for the total amount requested, made out to NH Department of Safety, Grants Management Unit.

Homeland Security and Emergency Management

State Homeland Security Exercise and Evaluation Program Application

APPENDIX B: PRESONNEL CALCULATION SHEET

Below is an active Excel sheet. To fill in you must first unprotect this document. On the Tools menu, click Unprotect Document. Next, double click anywhere on the table to begin filling in.

Homeland Security and Emergency Management

State Homeland Security Exercise and Evaluation Program Application